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目的探讨彩超在门脉高压相关性疾病防治中的应用价值。方法应用彩超对肝硬化及非门脉性上消化道出血患者门脉内径及其血流动力学进行检测;同时测定患者肝功能、凝血时间等生化指标;胃镜检测食管胃底静脉曲张程度;对实验组患者予以小剂量利尿剂配伍单硝酸异山梨酯进行预防治疗。结果肝硬化患者门脉内径显著大于对照组,且与胃镜下食管胃底静脉曲张程度正相关;但与Child-Pugh分级间无明显相关性;应用小剂量利尿剂配伍单硝酸异山梨酯预防性降低门脉压治疗后,门脉内径下降与胃镜下食管胃底静脉曲张程度下降成正相关;而与门脉高压相关性疾病的发生率成负相关。结论彩超可用于监测肝硬化患者门脉内径宽度及其血流动力学的变化,并预见门脉高压相关性疾病的发生;应用小剂量利尿剂配伍单硝酸异山梨酯预防性降低门脉压治疗,可以减少或避免门脉高压相关性疾病的发生。
Objective To explore the value of color Doppler ultrasound in the prevention and treatment of portal hypertension-related diseases. Methods The color Doppler echocardiography was used to detect the portal vein diameter and hemodynamics in patients with cirrhosis and non-portal upper gastrointestinal bleeding. The biochemical indexes such as liver function and clotting time were also measured. The degree of esophageal varices was detected by gastroscopy. Patients in the experimental group were given low-dose diuretics with isosorbide mononitrate for prevention and treatment. Results The portal vein diameter of patients with cirrhosis was significantly greater than that of the control group, and was positively correlated with the degree of esophagogastric varices under endoscopy. However, there was no significant correlation with the Child-Pugh grade. The low-dose diuretic plus isosorbide mononitrate Decreased portal pressure after treatment, decreased portal diameter and endoscopic esophageal varices degree is positively correlated; and portal hypertension and the incidence of a negative correlation between the incidence. Conclusion Color Doppler ultrasonography can be used to monitor the portal vein width and hemodynamic changes in patients with cirrhosis, and predict the occurrence of portal hypertension-related diseases; the application of low-dose diuretics with isosorbide mononitrate prophylaxis reduce portal pressure therapy , Can reduce or avoid the occurrence of portal hypertension related diseases.